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HomeMy WebLinkAbout6013 Mars Dr - Applications/Furnace - 12/24/2014City of Planning, peveldpment Ik transportation . ot�ins 281 N. College Ave P.O. Box 5©D �rt rorl; Collins, Co 8057<1 Phone 970-416-2740 Fax 224-6114 This application is to be rtsed to apply for the following perrgits only (clack all that apply). ❑ Air Conditioning ❑ Demolition (interior non-structural) 0 Electrical Alteration (not service change) CI Gas 1-191'tter I] Gas Log D I -looting Unit ❑ };avvn Sprinkler ❑ Mobile I -tome replacement CI Roerinq ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, pnovide make, model ar d manufacturer). Completo all appli0aabblle, inlfo/rmation on the apnlicatioq. Incomplete applications will not bn accented. application # " .� `� !L ��� 11 Dale — Lam/. Foy oiTJcc> r se onY _ .•.....,., u veroye .. _,,.,_. - rr commercial, is It: ❑ Bank ❑ Bar ❑ Church 0 Hotel/Motal Cl Medical office ❑'off ce ❑ kelail ❑ hest'aurant 0 Other (explain) _.�_ Is this s For ng.50 yoarg OF erna or more? 4 Yes q No Ifycs, You MaYneeq (o coldecP HislorrcPreseryptioq IF this is For a dcnialifion parmft, what year was the liuiiding constructed? If p,i0r ('O I9% , Yr)U rh%/! ryeE+d d) )sbftslo.^ R$S6SV1K1 t to vibip/f py/f/7 i'/!iS a/. hrOp- _. — — Description of wol-IC 'i'IF lawn spriiik;erJbaektlOW preventer, must list licensed plumber. If first -tine A/C, murt ll.t Iicu-Ir c, eieftftL'I3n. 4 sulrcontracto}•s;(r'stthecvnrpanYrranreorGy?Yoflftb/lirtir/ir CleclnGnn,�_.•errse,rr,_. ��—'Y+iumber� Roofer I hereby acknowledge that I Piave read this apphe3tion agtl state that the almve information is Coit!C'iCtt: and correct., I agree to rontply wlCh all'requihements Contained herein and'CIY ordinances and state laws requlating ball(II, q turrSUvctleit• i Icnowtllot"� permit is not'val•d GnkEl. it has been pair) and issued. A r tifenntc � P rint Mauer C-.J`^ �— .--�1,_ Sig •tDate